External or internal fixation in the treatment of non-reducible distal radial fractures?

Abstract

Background and purpose We have previously shown in a randomized study that in the first year after treatment, open reduction and internal fixation resulted in better grip strength and forearm rotation than closed reduction and bridging external fixation. In the present study, we investigated whether this difference persists over time.

Patients and methods The 50 patients included in the original study (mean age 53 years, 36 women) were sent a QuickDASH questionnaire and an invitation to a radiographic and clinical examination after a mean of 5 (3–7) years.

Results All 50 patients returned the QuickDASH questionnaire and 45 participated in the clinical and radiographic examination. In the internal fixation group, the grip strength was 95% (SD 12) of the uninjured side and in the external fixation group it was 90% (SD 21) of the uninjured side (p = 0.3). QuickDASH score, range of motion, and radiographic parameters were similar between the groups.

Interpretation The difference originally found between internal and external fixation in distal radial fractures at 1 year regarding grip strength and range of motion was found to diminish with time. At 5 years, both groups had approached normal values.

ML: project set-up, planning, collection and interpretation of data, statistics, and writing of the manuscript. DJ: project set-up and collection of data. MT: project set-up, and planning and revision of the manuscript. PK: revision of the manuscript. MG: data collection and revision of the manuscript. AA: project set-up, planning, statistics, and revision of the manuscript.

The project was supported by the Swedish Research Council (project 2031), the Greta and Johan Kock Foundation, the Alfred Österlund Foundation, the Maggie Stephens Foundation, the Thure Carlsson Foundation, and the Medical Faculty of Lund.

No competing interests declared.